Provider Demographics
NPI:1043515828
Name:CHAU, TAK WAI (LCSW)
Entity type:Individual
Prefix:
First Name:TAK WAI
Middle Name:
Last Name:CHAU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ISABEL
Other - Middle Name:
Other - Last Name:CHAU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSE
Mailing Address - Street 1:35 SANDY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050
Mailing Address - Country:US
Mailing Address - Phone:917-622-3558
Mailing Address - Fax:
Practice Address - Street 1:36 ROCKWOOD AVE
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTO
Practice Address - State:NY
Practice Address - Zip Code:11050
Practice Address - Country:US
Practice Address - Phone:917-622-3558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0824761041C0700X
NY0817181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical